AOR, adjusted OR. ORs and AORs were estimated in binary logistic regressions with the variable of survey year transformed to a variable ranging from 0 (for 2005) and 1 (for 2014). Thus, AORs represent change in odds over the whole study period. Variables of age, sex, race/ethnicity, student status, family income, parents’ presence in the household, substance use disorders, substance use treatment and any health insurance were included in the models.

↵a Questions regarding school counseling in NSDUH changed in 2009. As a result, data on school counseling for years 2005-2008 were not included in the analysis of temporal trends for this type of care.